| NPI | 1265068530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1895040) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DL14436) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2021-08-23 |