| NPI | 1083463715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA pending) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN10000334) |
| Enumeration Date | 2024-05-15 |
| Last Update Date | 2024-09-03 |