| NPI | 1528685849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: ME 4939) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0442000395) |
| Enumeration Date | 2020-07-02 |
| Last Update Date | 2022-07-27 |