| NPI | 1992989099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: SC 3019) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ DIO18179) |
| Enumeration Date | 2007-12-26 |
| Last Update Date | 2022-11-02 |