| NPI | 1487208971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1858444) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: NH 04775) |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2023-03-21 |