| NPI | 1144922758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 065754) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI03140000) |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2026-09-22 |