| NPI | 1306031794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02370900) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 009718) |
| 1223G0001X Dentist, General Practice (Licence: NY 053351) | |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2009-07-07 |