| NPI | 1063862589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: PA DS041666) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857250) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2019-03-06 |