| NPI | 1811378201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02678900) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 059228-01) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2020-09-30 |