| NPI | 1477614345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 29563) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MA 20991) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2014-09-30 |