| NPI | 1073824843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1855737) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL10955) |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2023-06-17 |