| NPI | 1407932486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 17840) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: RI 2398) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2007-07-08 |