| NPI | 1265620504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: NJ 22DI02345200) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NC 2017-00626) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2022-04-06 |