| NPI | 1548284334 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 0017) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 049178-1) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2014-01-31 |