| NPI | 1922182179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NJ DI020562) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 048190-1) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2016-11-02 |