| NPI | 1235852054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DL100722) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 108103) |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2025-07-01 |