| NPI | 1356768030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 058952) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019.031743) |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2022-03-08 |