| NPI | 1003153305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN19684) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MA DL11793) |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2024-02-06 |