| NPI | 1720229933 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN 21290) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 010223) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2016-10-06 |