| NPI | 1730203902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MO 2024041155) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NC 0058) |
| 1223E0200X Dentist, Endodontics (Licence: TX 26573) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2025-04-23 |