| NPI | 1912104407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: FL DN21142) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: NY 050403) |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2016-02-04 |