| NPI | 1104963149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL 17836) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 053087) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2015-05-14 |