NPI | 1386054799 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 060837) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 060837) |
Enumeration Date | 2014-05-07 |
Last Update Date | 2025-08-18 |