| NPI | 1245819622 |
|---|---|
| Former Name | MARY ELIZABETH MASSEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: AL 6931) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2023-06-29 |