| NPI | 1669648028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 14857) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02365700) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 26138) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401413436) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: LA 6000) | |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2019-07-22 |