| NPI | 1114333804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: VA 0401415976) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 29941) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2018-07-31 |