| NPI | 1295275758 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NJ 22DI02766100) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: PA DS042643) |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2020-10-05 |