| NPI | 1609697291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 064381) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI03055500) |
| Enumeration Date | 2024-10-17 |
| Last Update Date | 2024-10-17 |