| NPI | 1043580905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME DE4338) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D9660) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2016-10-22 |