| NPI | 1942539614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MA DN1856862) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 25130) |
| Enumeration Date | 2009-12-09 |
| Last Update Date | 2022-07-21 |