| NPI | 1851001754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 40152) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02939300) |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2023-12-15 |