| NPI | 1508359803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: GA DN123051) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS042046) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2025-01-24 |