| NPI | 1952862419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 061121) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NJ 22DI02811600) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2023-06-06 |