| NPI | 1558760066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ D11242900) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D009072) |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2024-06-30 |