| NPI | 1356681597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NJ 07001) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02625200) |
| Enumeration Date | 2013-02-25 |
| Last Update Date | 2024-02-06 |