| NPI | 1396010104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 057364-1) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02549200) |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2022-10-14 |