| NPI | 1144875493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02835800) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 17053) |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2022-11-14 |