| NPI | 1003058488 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DL13088) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 10558) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2022-07-21 |