| NPI | 1497353619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401417706) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1858859) |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2023-11-17 |