| NPI | 1427543610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1858221) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MA DL13643) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2021-06-03 |