| NPI | 1528349271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA DN1855688) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1855688) |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2023-04-05 |