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 |