| NPI | 1285749515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN22195) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 039271-1) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2022-07-21 |