| NPI | 1326418518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: LA 6936) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857088) |
| Enumeration Date | 2015-09-30 |
| Last Update Date | 2018-12-26 |