| NPI | 1841529179 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OR D10922) | 
| Additional Taxonomies | 122300000X Dentist (Licence: SC 8890) | 
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2009-12-16 | 
| Last Update Date | 2018-10-19 |