| NPI | 1689192627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: OH 30025830) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DS041470) |
| Enumeration Date | 2017-08-30 |
| Last Update Date | 2022-07-21 |