| NPI | 1447621784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: VA 0401417278) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401417278) |
| 122300000X Dentist (Licence: MA DL14294) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MA DL12778) | |
| Enumeration Date | 2015-10-13 |
| Last Update Date | 2025-08-06 |