| NPI | 1093827925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 19866) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 009634) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2010-11-03 |