| NPI | 1598028417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 101046) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ DI02503800) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2024-04-26 |