| NPI | 1720788227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 40617) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22D103077700) |
| Enumeration Date | 2023-03-06 |
| Last Update Date | 2025-08-07 |