| NPI | 1376806570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: VT 93923) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1855808) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2014-02-14 |