| NPI | 1114446200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22Di02700500) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 061504-01) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2023-05-10 |