| NPI | 1457107906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Additional Taxonomies | 126800000X Dental Assistant (Licence: NJ 22DP00585400) |
| Enumeration Date | 2024-04-25 |
| Last Update Date | 2024-05-08 |