| NPI | 1356414023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 049323) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 000173) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2009-02-11 |