| NPI | 1902283724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02595600) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN25024) |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2021-07-13 |