| NPI | 1689663213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: WI 7168-15) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: AZ 6447) |
| 1223E0200X Dentist Endodontics (Licence: CA 50102) | |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2014-06-15 |