| NPI | 1023785334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 14051) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02862000) |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2026-04-06 |