NPI | 1497201503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1858890) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 11714) |
Enumeration Date | 2016-08-29 |
Last Update Date | 2023-02-13 |