| NPI | 1588748511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CT 009722) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 048763) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2013-11-05 |