| NPI | 1598077810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1855477) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NY 056018) |
| Enumeration Date | 2010-07-02 |
| Last Update Date | 2012-08-15 |