| NPI | 1770819245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: WA DE60190114) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: NY 054714) |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2015-07-23 |