| NPI | 1396520508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: NH 05326) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL15801) |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2026-02-13 |