| NPI | 1780432989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 111545) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI03044600) |
| Enumeration Date | 2024-05-11 |
| Last Update Date | 2025-06-30 |