| NPI | 1831877711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DL100076) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: NJ 22HI01261400) |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2024-08-14 |