| NPI | 1962716449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: NY 055979-1) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 1223E0200X Dentist, Endodontics (Licence: CT 010966) | |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2013-07-29 |