| NPI | 1639259120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: SC 8827) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NY 049127) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2018-06-16 |