| NPI | 1275010274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1858039) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1858039) |
| 1223G0001X Dentist, General Practice (Licence: MA 1858039) | |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2018-07-23 |