| NPI | 1962194910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NJ 22DI02975000) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02975000) |
| Enumeration Date | 2023-05-25 |
| Last Update Date | 2024-03-05 |