| NPI | 1619619970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 14513) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 063342) |
| Enumeration Date | 2022-04-08 |
| Last Update Date | 2025-10-18 |