| NPI | 1366967663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: PA DS041244) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041244) |
| 1223E0200X Dentist Endodontics (Licence: NY 060268) | |
| 1223E0200X Dentist Endodontics (Licence: CO DEN.00205880) | |
| 1223G0001X Dentist General Practice (Licence: NY 060268) | |
| Enumeration Date | 2017-08-08 |
| Last Update Date | 2024-07-09 |