| NPI | 1518350479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 12935) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 059273-1) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2021-05-10 |