| NPI | 1215442579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1857868) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: RI DEN03400) |
| Enumeration Date | 2017-12-08 |
| Last Update Date | 2018-07-17 |