NPI | 1205590593 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: TX 40215) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DL14923) |
Enumeration Date | 2021-10-24 |
Last Update Date | 2024-01-23 |