| NPI | 1134237258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN20875) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 20875) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2020-01-27 |