| NPI | 1639530090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02625600) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02625600) |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2020-04-02 |