| NPI | 1710790183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 14583) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN10001096) |
| Enumeration Date | 2025-01-29 |
| Last Update Date | 2025-10-09 |