NPI | 1548919079 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 18513) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 063816) |
1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401419367) | |
Enumeration Date | 2022-03-22 |
Last Update Date | 2025-09-10 |