| NPI | 1407497688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22D102772600) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02772600) |
| Enumeration Date | 2019-09-30 |
| Last Update Date | 2024-08-16 |