| NPI | 1962694125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 17605) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22D102702701) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2026-05-15 |