| NPI | 1821612086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1858915) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MA DL14408) |
| Enumeration Date | 2020-06-03 |
| Last Update Date | 2021-03-23 |