| NPI | 1518487271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 060777-01) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 12390) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-23 |
| Last Update Date | 2020-04-29 |