| 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 |