| NPI | 1437670957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1857683) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA DN1857683) |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2019-12-05 |