NPI | 1194004499 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 057202) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 60691) |
Enumeration Date | 2011-08-04 |
Last Update Date | 2014-06-15 |