| NPI | 1083710438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: AK 235832) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901019442) |
| 1223E0200X Dentist, Endodontics (Licence: MI 2901019442) | |
| 1223E0200X Dentist, Endodontics (Licence: TX 36891) | |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2026-02-28 |