| NPI | 1851080998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NY 064113) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NJ 22DI03052700) |
| Enumeration Date | 2023-05-04 |
| Last Update Date | 2024-09-05 |