| NPI | 1801550199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1859234) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN26511) |
| Enumeration Date | 2021-10-24 |
| Last Update Date | 2021-10-24 |