NPI | 1356697361 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: NJ 22DI02545300) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: PR 2867) |
Enumeration Date | 2012-07-27 |
Last Update Date | 2021-07-10 |