| NPI | 1326774639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02924500) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 064439) |
| Enumeration Date | 2022-07-28 |
| Last Update Date | 2025-11-06 |