| NPI | 1891346037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 38401) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL14190) |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2022-12-06 |