| NPI | 1528414455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 059206-1) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 059206-1) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2022-08-30 |