| NPI | 1497062764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1858544) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 25971) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2025-12-09 |