| NPI | 1215418108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: SC 9369) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL 23304) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2019-07-18 |