| NPI | 1518651041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI03025600) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NJ 22DR03833) |
| Enumeration Date | 2023-06-07 |
| Last Update Date | 2024-05-31 |