| NPI | 1861791659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22D102504000) |
| Enumeration Date | 2011-03-20 |
| Last Update Date | 2019-08-15 |