| NPI | 1437672649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 063916) |
| Additional Taxonomies | 122300000X Dentist (Licence: IA 09400) |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2024-06-28 |