| NPI | 1588078596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02828000) |
| Additional Taxonomies | 122300000X Dentist (Licence: DC DEN1001416) |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2026-04-27 |