| NPI | 1841501723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1856361) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI 02433600) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2014-06-23 |