| NPI | 1083023063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NH 04064) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856638) |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2016-07-27 |