| NPI | 1518579499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NH 04592) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1858852) |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2024-04-24 |