| NPI | 1659572410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02283300) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 051304) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2007-07-08 |