| NPI | 1528045184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NY 052386) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 100398) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021002442) | |
| Enumeration Date | 2005-12-26 |
| Last Update Date | 2021-04-06 |