| NPI | 1467202002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI03149800) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0442000515) |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2026-06-11 |