| NPI | 1508288739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02563100) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 058998-1) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-01-07 |
| Last Update Date | 2020-10-07 |