| NPI | 1194342386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02828300) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS042676) |
| 122300000X Dentist (Licence: PA DS042676) | |
| Enumeration Date | 2020-07-03 |
| Last Update Date | 2023-12-19 |