| 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 |