| NPI | 1235677204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 0593891-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02658500) |
| 1223G0001X Dentist, General Practice (Licence: SC DGD.8900 GD) | |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2021-06-29 |