| NPI | 1700143724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02493600) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 055969) |
| Enumeration Date | 2012-04-15 |
| Last Update Date | 2023-11-09 |