| NPI | 1285037515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1856748) |
| Additional Taxonomies | 122300000X Dentist (Licence: NH 04232) |
| 122300000X Dentist (Licence: ME DEN4427) | |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2022-07-21 |