| NPI | 1205197431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NH 04287) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1855945) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2022-02-08 |