| NPI | 1245481456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1855331) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 009895) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2012-08-30 |