NPI | 1306254701 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DR02816) |
Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: PR 3222) |
Enumeration Date | 2014-07-29 |
Last Update Date | 2021-07-30 |