| NPI | 1336297068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME 4020) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21173) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2022-09-03 |