| NPI | 1104145804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 056120-1) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 56120) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2023-07-07 |