| NPI | 1174905665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: PR 3421) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CT 12313) |
| 1223P0300X Dentist, Periodontics (Licence: VT 016.0133955) | |
| 1223P0300X Dentist, Periodontics (Licence: MA DN1857033) | |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2025-08-21 |