| NPI | 1619527660 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: DC DEN2000090) | 
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 060697) | 
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02771600) | |
| Enumeration Date | 2019-09-11 | 
| Last Update Date | 2025-01-16 |