| NPI | 1114554219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 125Q00000X Oral Medicinist (Licence: MA DN1858703) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1858703) |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2023-06-14 |