| NPI | 1720655848 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 063644) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02868500) |
| Enumeration Date | 2021-06-08 |
| Last Update Date | 2025-01-22 |