| NPI | 1699978924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 056467) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: RI LD00017) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2019-12-02 |