| NPI | 1790433845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 13939) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02911200) |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2023-12-12 |