| NPI | 1578865507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NM DD22027) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 26101) |
| Enumeration Date | 2010-11-24 |
| Last Update Date | 2023-08-28 |