| NPI | 1558047241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 41136) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI3052100) |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2024-12-11 |