| NPI | 1083971956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: KY 9200) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 9200) |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2016-09-22 |