| NPI | 1336495670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 1452390) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413712) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2023-10-05 |