| NPI | 1528495082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 057869) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856028) |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2016-03-16 |