| NPI | 1538338892 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 054577) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 21985) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2012-09-10 |