| NPI | 1245580745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NC 10948) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1856123) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2020-11-25 |