| NPI | 1891320966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN1859324) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1859324) |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2023-11-04 |