| NPI | 1184084683 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1857115) |
| Additional Taxonomies | 122300000X Dentist (Licence: RI DEN03313) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2017-07-18 |