| NPI | 1396128104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NH 04341) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1856908) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2020-02-11 |