NPI | 1588815005 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA 0401413056) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413056) |
Enumeration Date | 2008-10-02 |
Last Update Date | 2024-11-19 |