| NPI | 1578524872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: AZ D4933) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 055939) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2018-09-25 |