| NPI | 1578728457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: WV 3832) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WV 3832) |
| 1223E0200X Dentist, Endodontics (Licence: PA DS038864) | |
| Enumeration Date | 2008-07-21 |
| Last Update Date | 2016-04-15 |