| NPI | 1710541222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NJ 22DI02812300) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 061469-01) |
| Enumeration Date | 2019-04-30 |
| Last Update Date | 2025-05-16 |