| NPI | 1376031203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN27530) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 061673) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2022-09-27 |