| NPI | 1801557723 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 39390) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1859492) |
| Enumeration Date | 2022-01-03 |
| Last Update Date | 2023-12-29 |