| NPI | 1497910954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02382600) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ DI02382600) |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2017-11-28 |