| NPI | 1629342092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: WA 60055426) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL DN 19447) |
| Enumeration Date | 2012-03-02 |
| Last Update Date | 2016-02-22 |