| NPI | 1942559174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DF11839) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL13914) |
| 122300000X Dentist (Licence: MA DL13189) | |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2022-07-11 |