NPI | 1518314087 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 12188) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1857296) |
Enumeration Date | 2016-05-15 |
Last Update Date | 2023-11-03 |