| NPI | 1306254701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PR 3222) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DR02816) |
| Enumeration Date | 2014-07-29 |
| Last Update Date | 2026-07-24 |