| NPI | 1831811876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DL15347) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MA DL15347) |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2023-04-24 |