| NPI | 1588975965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1855409) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: RI DEN03153) |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2014-11-14 |