| NPI | 1689933897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 057363-1) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN19649) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2016-04-23 |