| NPI | 1528357308 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02720500)  | 
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 11165)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-04-01 | 
| Last Update Date | 2023-01-07 |