NPI | 1578184024 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 07120) |
Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02850800) |
Enumeration Date | 2020-05-06 |
Last Update Date | 2023-07-06 |