| NPI | 1053561035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: AZ D07308) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY P57185) |
| 122300000X Dentist (Licence: AZ D7308) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 054398) | |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2022-03-07 |