| NPI | 1750075925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1859919) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: CT 14790) |
| Enumeration Date | 2023-06-08 |
| Last Update Date | 2026-07-29 |