| NPI | 1346240942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1856777) |
| Additional Taxonomies | 1223D0001X Dentist, Dental Public Health (Licence: NC 8036) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2019-02-07 |