| NPI | 1083878771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 055481) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 22237) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2012-04-25 |