NPI | 1215328356 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 122300000X Dentist (Licence: FL dn23958) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DN1858216) |
1223E0200X Dentist, Endodontics (Licence: MA DN1858216) | |
1223G0001X Dentist, General Practice (Licence: MA DN1858216) | |
Enumeration Date | 2015-02-11 |
Last Update Date | 2022-06-20 |