| NPI | 1497480537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA DN10001105) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NH 04957) |
| 122300000X Dentist (Licence: VT 016.0134113) | |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2025-11-20 |