| NPI | 1952503799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 049857) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 0498371) |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2023-01-30 |