| NPI | 1821739863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 063628) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22D102978900) |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2023-12-04 |