| NPI | 1487964375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA DN1855508) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NH 03870) |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2016-05-11 |