| NPI | 1174898944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1855818) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 27762) |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2014-07-28 |