| NPI | 1558604264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 058344) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS039941) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2018-10-03 |