| NPI | 1285064048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1858250) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 057007-1) |
| Enumeration Date | 2013-11-14 |
| Last Update Date | 2023-08-18 |