| NPI | 1306543343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI03067900) |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2025-06-04 |