| NPI | 1356617831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1857185) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 0577991) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2016-07-05 |