| NPI | 1750084794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 64196) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 064196) |
| Enumeration Date | 2023-03-27 |
| Last Update Date | 2025-12-08 |