| NPI | 1235748328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 062902) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02807700) |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2024-01-23 |