| NPI | 1790184968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: LA 7487) |
| Additional Taxonomies | 122300000X Dentist (Licence: OR D10119) |
| 1223E0200X Dentist, Endodontics (Licence: OR D10119) | |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2023-08-16 |