| NPI | 1275101099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: DC DEN2000120) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 18569) |
| 1223G0001X Dentist, General Practice (Licence: NJ 22DR03628) | |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2025-09-16 |