| NPI | 1225790306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02912500) |
| Additional Taxonomies | 122300000X Dentist (Licence: CA 107039) |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2023-07-14 |