NPI | 1649658691 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 058555) |
Additional Taxonomies | 122300000X Dentist (Licence: NY 058555) |
Enumeration Date | 2015-05-11 |
Last Update Date | 2019-07-09 |