| NPI | 1699344135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02854100) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN25985) |
| Enumeration Date | 2021-06-19 |
| Last Update Date | 2024-10-21 |