| NPI | 1063269140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN10000255) |
| Additional Taxonomies | 122300000X Dentist (Licence: ZZ 2844) |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-12-12 |