| NPI | 1265838494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: FL DN195517) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN19517) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: NY 057733-1) | |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2022-04-12 |