| NPI | 1588803407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 009629) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 009629) |
| 122300000X Dentist (Licence: NY 50 052767) | |
| Enumeration Date | 2009-02-17 |
| Last Update Date | 2010-10-26 |