| NPI | 1831921147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 126800000X Dental Assistant (Licence: NJ 22D102593103) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02593103) |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-11-27 |