| NPI | 1417593278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02782601) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02782600) |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2021-04-21 |