| NPI | 1619527660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02771600) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 060697) |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2019-09-11 |