| NPI | 1811220296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ DI24126) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 054676) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2009-09-16 |