| NPI | 1205199569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA S57780302) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA S57780302) |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2020-08-31 |