| NPI | 1194027110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 010320) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1855607) |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2017-02-14 |