| NPI | 1851799365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MD LL733) |
| Additional Taxonomies | 101YS0200X Counselor, School |
| 1223P0700X Dentist, Prosthodontics (Licence: MA DF11416) | |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2019-04-19 |