| NPI | 1356045652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02904600) |
| Enumeration Date | 2023-03-29 |
| Last Update Date | 2023-03-29 |