| NPI | 1215133061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CA 53116) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MA DN-21454-1) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2009-02-18 |