| NPI | 1144548306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 010220) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02375200) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2021-07-28 |