| NPI | 1619552312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: NY 063756) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: MA DN10000162) |
| Enumeration Date | 2021-03-14 |
| Last Update Date | 2025-06-19 |