| NPI | 1255098794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02873400) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 13289) |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2021-12-03 |