| NPI | 1730665910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401417130) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 2DI02723400) |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2020-08-12 |