| NPI | 1689032492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02831200) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 059194) |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2024-07-09 |