| NPI | 1720596778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1859260) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO DEN.00203424) |
| 1223G0001X Dentist, General Practice (Licence: CT 12679) | |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2021-12-08 |