| NPI | 1235514266 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 058712) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 122300000X Dentist (Licence: NJ 22DI02605300) | |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2017-04-03 |