| NPI | 1417218215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA DN1855975) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1855975) |
| Enumeration Date | 2012-06-07 |
| Last Update Date | 2024-09-19 |