| NPI | 1255569026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: GA DN014353) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS037859) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2018-09-21 |