| NPI | 1124193214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MA 21942) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NC 7786) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2016-08-30 |