| NPI | 1780255745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NJ 22DI03061900) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 106507) |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2026-06-24 |