| NPI | 1477287373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: ME DE4930) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NH 05087) |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2025-07-02 |