| NPI | 1295181931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 059349) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 059349) |
| 122300000X Dentist (Licence: NJ 22DI02745800) | |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2023-05-11 |