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 |