| NPI | 1114366705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 12945) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1856292) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2025-03-30 |