| NPI | 1548852916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 062429) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 14495) |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2025-11-05 |