| NPI | 1962879148 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: DC DEN1001876)  | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| 122300000X Dentist (Licence: FL DN20925)  | |
| Enumeration Date | 2015-08-24 | 
| Last Update Date | 2018-11-06 |