| NPI | 1568635837 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VT 016.0134179) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1855175) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2023-10-16 |