| NPI | 1821393943 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 056022) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN2855589) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2025-01-17 |