| NPI | 1992304497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 111313) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02776300) |
| 122300000X Dentist (Licence: PA DS042921) | |
| Enumeration Date | 2020-10-26 |
| Last Update Date | 2025-05-29 |