| NPI | 1710947932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: NY 045311-1) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 045311-1) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2007-07-08 |