| NPI | 1992171292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: CA 100091) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: NY 057064) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2016-08-23 |