| NPI | 1528822004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DL15981) |
| Additional Taxonomies | 1223D0001X Dentist Dental Public Health (Licence: MA DL15981) |
| Enumeration Date | 2024-02-06 |
| Last Update Date | 2024-03-01 |