| NPI | 1962126862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DL15988) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL15374) |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2024-08-08 |