| NPI | 1144756719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 39346) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901022326) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2024-07-26 |