| NPI | 1023501673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 062326-01) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA 8953) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2023-11-06 |