| NPI | 1225521768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA DN1858015) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NH 04486) |
| Enumeration Date | 2018-06-09 |
| Last Update Date | 2019-08-22 |