| 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 |