| NPI | 1972293322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 14862) |
| Additional Taxonomies | 122300000X Dentist (Licence: NJ 22DI03152800) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI03152800) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 14862) | |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2026-08-04 |