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 |