NPI | 1003226432 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02593100) |
Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02593100) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-05-07 |
Last Update Date | 2018-08-23 |