| NPI | 1609322270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22dI02877200) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN 22205) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2023-01-09 |