| NPI | 1063586261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: KY 7122) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 7122) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2014-09-11 |