| NPI | 1104039981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 0534721) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 0534721) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2024-08-22 |