| NPI | 1386931624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 055549-1) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 011016) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2013-09-19 |