| NPI | 1427454198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 057769) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901021188) |
| Enumeration Date | 2014-11-07 |
| Last Update Date | 2024-04-20 |