| NPI | 1265445746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 16140) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NH 2084) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-07-08 |