| NPI | 1255719969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 50 058166) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NJ 22DI02597200) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: FL DN20172) | |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2019-05-08 |