| NPI | 1457704207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME 4488) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 100457) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2025-11-01 |