| NPI | 1164784260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 057700) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS039816) |
| 122300000X Dentist (Licence: CT 10868) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2022-07-21 |