NPI | 1982046603 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 058079) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02612800) |
Enumeration Date | 2013-07-23 |
Last Update Date | 2016-01-15 |