| NPI | 1235623307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME DEN4698) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1858040) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2019-08-07 |