| NPI | 1083953533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22DI02565400) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02565400) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2022-07-13 |