| NPI | 1386623387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NC 8324) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA 011464) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401007993) | |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2023-03-07 |