| NPI | 1194893917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 0440511) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 08858) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: FL 15773) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 08858) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: FL 15773) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: NY 0440511) | |
| 1223G0001X Dentist, General Practice (Licence: NY 0440511) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2017-01-06 |