| NPI | 1457802902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA DN1859262) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: GA DN015306) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2023-03-01 |