| NPI | 1013205921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1857739) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 15005) |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2018-03-17 |