| NPI | 1689236879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: TN 11501) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL14012) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2022-09-14 |