| NPI | 1275910515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 11798) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1857174) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2017-06-26 |