| NPI | 1013792217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA DL100329) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MA DL15809) |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2024-07-25 |