NPI | 1982979506 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NY 8683136) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MD 15660) |
1223P0221X Dentist, Pediatric Dentistry (Licence: NJ 22DI02558300) | |
Enumeration Date | 2012-03-15 |
Last Update Date | 2016-11-03 |