| NPI | 1700198769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NJ 22DI02391300) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 053203-1) |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2023-08-09 |