NPI | 1659856847 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MA DN1859718) |
Additional Taxonomies | 122300000X Dentist (Licence: VT 016.0133878) |
Enumeration Date | 2018-10-03 |
Last Update Date | 2023-04-26 |