| NPI | 1144672270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 101937) |
| Additional Taxonomies | 122300000X Dentist (Licence: NY 059183) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2019-10-08 |