| NPI | 1053054916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MA DN1859380) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1859380) |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2024-10-30 |