| NPI | 1417219536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22Di02982200) |
| Additional Taxonomies | 122300000X Dentist (Licence: ME DEN4742) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2026-03-09 |