| NPI | 1205590593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 40215) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL14923) |
| Enumeration Date | 2021-10-24 |
| Last Update Date | 2024-01-23 |