NPI | 1093005167 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 056318) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02591000) |
Enumeration Date | 2011-04-11 |
Last Update Date | 2016-12-22 |