| NPI | 1770968448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AZ D009852) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02611100) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2022-07-21 |