| NPI | 1366136905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 1456154) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NH 04863) |
| Enumeration Date | 2023-06-06 |
| Last Update Date | 2023-08-14 |