| NPI | 1588843528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 010057) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 053667-1) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 053667-1) | |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2010-01-25 |