| NPI | 1831351055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 055400-1) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CA 58174) |
| Enumeration Date | 2008-06-29 |
| Last Update Date | 2019-09-10 |