| NPI | 1306226949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1857585) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 062273) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2022-07-20 |