| NPI | 1649623935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DL12976) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.031947) |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2022-07-21 |