| NPI | 1376240713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DL16020) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL15782) |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2024-03-19 |