| NPI | 1639855653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 064981) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI03086200) |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2025-09-11 |