| NPI | 1801108014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 054941-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22D102429500) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2012-09-05 |