| NPI | 1851706485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02701800) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN20984) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2024-06-24 |