| NPI | 1023292844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 21300) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA DN21300) |
| Enumeration Date | 2007-12-28 |
| Last Update Date | 2020-06-22 |