| NPI | 1811209604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: CT 010941) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: NY 056104) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2018-10-25 |