| NPI | 1902597495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA DN1859789) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: RI STUDENT) |
| 1223G0001X Dentist General Practice (Licence: MA STUDENT) | |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-06-13 |