| NPI | 1366892085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1857547) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MA DL12923) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2022-07-21 |