| NPI | 1598461493 |
|---|---|
| Former Name | GABRIELLE DEMICCO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 064739) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-02-01 |
| Last Update Date | 2025-09-17 |