| NPI | 1295048361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WI 7147-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: ME DEN4151) |
| 122300000X Dentist (Licence: MA DN1855663) | |
| Enumeration Date | 2010-07-19 |
| Last Update Date | 2023-06-20 |