| NPI | 1326422296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 059363) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041110) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-07-10 |
| Last Update Date | 2019-01-27 |