| NPI | 1992052674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: NM DD3670) |
| Additional Taxonomies | 122300000X Dentist (Licence: NM DD3670) |
| 1223E0200X Dentist Endodontics (Licence: OK 7098) | |
| 1223G0001X Dentist General Practice (Licence: NM DD3670) | |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2022-07-20 |