| NPI | 1508597931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 7577) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02961400) |
| 122300000X Dentist (Licence: NY 063530) | |
| Enumeration Date | 2022-06-17 |
| Last Update Date | 2024-06-30 |