NPI | 1437824703 |
---|---|
Other Name | TRACY MA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: NH 04699) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DN1859148) |
Enumeration Date | 2021-08-10 |
Last Update Date | 2021-10-17 |