| NPI | 1225779663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: ME DEN5046) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NH 50255) |
| Enumeration Date | 2022-04-06 |
| Last Update Date | 2025-09-08 |