| NPI | 1295315554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 062616) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22D102878500) |
| Enumeration Date | 2021-04-12 |
| Last Update Date | 2025-05-13 |