| NPI | 1982006995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: TX 33982) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL12417) |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2021-12-17 |