| NPI | 1912697244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: NJ 22DI02869000) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02869000) |
| Enumeration Date | 2023-05-10 |
| Last Update Date | 2024-05-14 |