| NPI | 1972713535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: CT 009304) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 9304) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2015-06-02 |