| NPI | 1508190943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: PR 2837) |
| Additional Taxonomies | 122300000X Dentist (Licence: PR 2837) |
| 122300000X Dentist (Licence: NY 054436) | |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2025-06-28 |