NPI | 1730742867 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02934500) |
Additional Taxonomies | 122300000X Dentist (Licence: LA 6960) |
122300000X Dentist (Licence: NJ 22DI02934500) | |
Enumeration Date | 2019-04-15 |
Last Update Date | 2023-11-06 |