| NPI | 1659866101 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1860034) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.031810) |
| Enumeration Date | 2018-06-27 |
| Last Update Date | 2023-11-29 |