| NPI | 1699337139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02801300) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DR03426) |
| Enumeration Date | 2019-07-04 |
| Last Update Date | 2020-08-30 |