| NPI | 1942062567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: RI DEN03777) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA DN10000543) |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2025-07-17 |