| NPI | 1326707126 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: TX 41884) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02962600) |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2025-11-18 |