| NPI | 1477174779 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 110120) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 122300000X Dentist (Licence: MA DN1858893) | |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2024-06-24 |