| NPI | 1942613518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CT 13705) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ DI02569200) |
| 1223P0300X Dentist, Periodontics (Licence: NJ 22DI02569200) | |
| 1223P0300X Dentist, Periodontics (Licence: NY 058626-1) | |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2024-04-19 |