NPI | 1356894166 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MA DN1857818) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 61982) |
Enumeration Date | 2016-07-28 |
Last Update Date | 2018-03-17 |