NPI | 1932185790 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: DE G3-0000497) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ DI022019) |
Enumeration Date | 2005-12-22 |
Last Update Date | 2019-08-16 |