| NPI | 1972914331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 50057933) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 16383) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2022-03-04 |