| NPI | 1912112624 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NH 03541) | 
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: FL 17486) | 
| 1223E0200X Dentist, Endodontics (Licence: MA 21565) | |
| 1223E0200X Dentist, Endodontics (Licence: ME 4037) | |
| Enumeration Date | 2007-05-14 | 
| Last Update Date | 2008-05-23 |