| NPI | 1912988197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 042977) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 042977) |
| Enumeration Date | 2005-11-07 |
| Last Update Date | 2024-08-22 |