| NPI | 1629276498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 0401410098) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 051253-1) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2009-05-07 |