| NPI | 1962737239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: DC DEN10001016) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1855203) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2022-09-11 |