NPI | 1699158691 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 06799) |
Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI02738600) |
122300000X Dentist (Licence: NY 058493) | |
Enumeration Date | 2015-07-08 |
Last Update Date | 2024-01-11 |