| NPI | 1083116156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02791400) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 061567) |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2022-04-04 |