| NPI | 1023363629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 1856232) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DL11607) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2016-04-13 |