| NPI | 1104317494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1858229) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MA DL13614) |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2024-01-12 |