| NPI | 1093305310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: RI DEN03586) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1858902) |
| Enumeration Date | 2021-01-20 |
| Last Update Date | 2021-11-01 |