| NPI | 1497098511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CT 11547) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 058076) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: PA DS039858) | |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2019-01-29 |