NPI | 1003014614 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MA DL12853) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DL12854) |
122300000X Dentist (Licence: MA DL12884) | |
Enumeration Date | 2007-07-05 |
Last Update Date | 2017-02-16 |