| NPI | 1770938474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: RI DEN03346) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857290) |
| Enumeration Date | 2016-04-30 |
| Last Update Date | 2025-06-25 |