| NPI | 1447267083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: VT 2284) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MA 20675) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2019-08-15 |