| NPI | 1427486315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1856416) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856416) |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2020-07-22 |