| NPI | 1356316871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 58396) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901019189) |
| 1223E0200X Dentist, Endodontics (Licence: AZ 8774) | |
| Enumeration Date | 2006-02-19 |
| Last Update Date | 2021-12-29 |