| NPI | 1154339562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 19484) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 19602) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2025-09-11 |