| NPI | 1972280725 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA DDS109235) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02971800) |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2024-01-11 |