| NPI | 1427403773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NJ 22DI02692500) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1223P0221X Dentist Pediatric Dentistry (Licence: NY 059536-1) | |
| Enumeration Date | 2016-04-24 |
| Last Update Date | 2021-05-17 |