| 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 |