| NPI | 1891997987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 21587) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: CA 57525) |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2009-10-26 |