| NPI | 1831888510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DA09097) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL15843) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2024-06-20 |