| NPI | 1770378721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN10001125) |
| Additional Taxonomies | 122300000X Dentist (Licence: RI DEN03821) |
| Enumeration Date | 2025-04-10 |
| Last Update Date | 2025-09-29 |