| NPI | 1407386139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: FL DN22887) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857625) |
| 1223E0200X Dentist, Endodontics (Licence: MA DN1857625) | |
| 1223G0001X Dentist, General Practice (Licence: MA DN1857625) | |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2020-05-29 |