| NPI | 1235573486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MD 15162) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: DC DEN1001123) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2023-05-09 |