| NPI | 1770920910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: GA DN014621) |
| Additional Taxonomies | 122300000X Dentist (Licence: GA DN014621) |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2019-07-26 |