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 |