| NPI | 1114562881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 061716) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI2742500) |
| Enumeration Date | 2019-11-16 |
| Last Update Date | 2021-10-05 |