| NPI | 1548368038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 11044) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 000033-1) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2021-05-11 |