| NPI | 1811445042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: GA dn015166) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: SC 11259) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2026-01-26 |