| NPI | 1215292024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA dn1856382) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL11606) |
| Enumeration Date | 2012-07-08 |
| Last Update Date | 2014-01-21 |