| NPI | 1063827673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 41029) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 15558) |
| 1223G0001X Dentist, General Practice (Licence: NY 062927-01) | |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2024-10-06 |