| NPI | 1104486521 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1858441) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1858441) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2022-12-28 |