| NPI | 1588192819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CA 109911) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 000105) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: NY 061530) | |
| Enumeration Date | 2017-05-31 |
| Last Update Date | 2024-06-02 |