| NPI | 1932474665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401418600) |
| Additional Taxonomies | 122300000X Dentist (Licence: WA DE60781761) |
| 1223E0200X Dentist, Endodontics (Licence: VA 0401418600) | |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2025-02-01 |