NPI | 1912117821 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NJ 22DI02270800) |
Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: NJ 22DI02270800) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2023-05-12 |