| NPI | 1942585658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 059719-1) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: TX 32350) |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2021-02-22 |