| NPI | 1740741040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NY 061176-01) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02778600) |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2023-11-10 |