| NPI | 1417578089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02833900) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 063673) |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2024-07-08 |