| NPI | 1417581323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1858598) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0442000364) |
| Enumeration Date | 2020-02-29 |
| Last Update Date | 2021-02-11 |