| NPI | 1295090462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 057377-1) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 32581) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2022-03-13 |