| NPI | 1275507162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NJ DI20510) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02051000) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2023-02-01 |