| NPI | 1114456753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02701100) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 103143) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 061002) | |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2025-12-26 |