| NPI | 1336834092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02881500) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN26374) |
| Enumeration Date | 2023-04-10 |
| Last Update Date | 2023-04-10 |