| NPI | 1053944454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN24622) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN24622) |
| Enumeration Date | 2020-02-14 |
| Last Update Date | 2022-06-28 |