| NPI | 1649957267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1859836) |
| Additional Taxonomies | 122300000X Dentist (Licence: RI DEN03668) |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2023-12-21 |