| NPI | 1679241947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN25729) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02851700) |
| Enumeration Date | 2021-09-01 |
| Last Update Date | 2025-05-27 |