NPI | 1376286773 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 1407877137) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 193400000X) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2022-04-14 |
Last Update Date | 2023-07-10 |