| NPI | 1851973796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02841900) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 062699) |
| Enumeration Date | 2021-04-21 |
| Last Update Date | 2022-08-31 |