| NPI | 1083028617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: SC 463) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 3203) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2014-06-11 |