| NPI | 1700378221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: NH 04434) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857972) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-07-19 |