NPI | 1720625528 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02779700) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI027797) |
Enumeration Date | 2019-11-29 |
Last Update Date | 2021-07-22 |