| NPI | 1457469520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MA 20554) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MI 2901018075) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2015-02-26 |