| NPI | 1114342797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN23990) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 057767) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 057767) | |
| Enumeration Date | 2014-02-19 |
| Last Update Date | 2021-07-28 |