NPI | 1659753598 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MA DN1857102) |
Additional Taxonomies | 122300000X Dentist (Licence: FL DN21338) |
Enumeration Date | 2015-06-27 |
Last Update Date | 2016-01-19 |