| NPI | 1932766755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: CA 104645) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 39382) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2024-09-29 |