| NPI | 1508001439 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 051361) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 27878) |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2012-10-24 |