| NPI | 1043314156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: PR 2276) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 046351) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2014-05-09 |