NPI | 1316351364 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MD 16908) |
Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: VA 0401416929) |
1223E0200X Dentist, Endodontics (Licence: DC DEN1002102) | |
1223G0001X Dentist, General Practice (Licence: NY 05896201) | |
Enumeration Date | 2014-06-18 |
Last Update Date | 2022-07-06 |