NPI | 1598389678 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 1981032) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 13940) |
Enumeration Date | 2020-06-03 |
Last Update Date | 2024-01-17 |