NPI | 1376714535 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02362300) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 052029) |
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 062028) | |
Enumeration Date | 2008-03-17 |
Last Update Date | 2023-10-20 |