| NPI | 1902212764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: NY 058535) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: FL DN20716) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2017-05-08 |