| 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 |