| NPI | 1760869457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 12629) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019.031527) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 060919-01) | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2020-07-30 |