| NPI | 1396107355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MA DN1857278) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1857278) |
| Enumeration Date | 2016-03-28 |
| Last Update Date | 2020-07-07 |