| NPI | 1023376167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: PR 2893) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: PR 2893) |
| 1223G0001X Dentist General Practice (Licence: NY 056204) | |
| 1223P0221X Dentist Pediatric Dentistry (Licence: NY 056204) | |
| Enumeration Date | 2012-04-26 |
| Last Update Date | 2022-03-24 |