| NPI | 1780023275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: ID D4493-EN) |
| Additional Taxonomies | 122300000X Dentist (Licence: MT DEN-DEN-LIC-5941) |
| 122300000X Dentist (Licence: TX 30909) | |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2020-10-01 |