| NPI | 1285947929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1856353) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: RI CDEN03081) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2013-09-30 |