| NPI | 1073002697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NJ 22DI02885200) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: PA DS042624) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2024-06-06 |