| NPI | 1447358320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA DF11965) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DL10799) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2023-08-08 |