NPI | 1013228287 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 055613) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 11259) |
Enumeration Date | 2010-06-23 |
Last Update Date | 2017-03-10 |