NPI | 1609003060 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 056027-1) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MO 2020013343) |
Enumeration Date | 2009-06-12 |
Last Update Date | 2021-02-22 |