| NPI | 1023240298 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: NH 03757) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1855217) |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2009-12-11 |