| NPI | 1548691017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1856426) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN24672) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2023-01-19 |