| NPI | 1316615214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02864200) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN26099) |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2021-09-22 |