| NPI | 1477811651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CA 104830) |
| Additional Taxonomies | 122300000X Dentist (Licence: NV 7448) |
| 122300000X Dentist (Licence: MI 2901021804) | |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2024-07-09 |