| NPI | 1144716200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 061007) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DR03271) |
| Enumeration Date | 2018-07-02 |
| Last Update Date | 2023-03-13 |