| NPI | 1467703629 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 30795) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1856137) |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2018-04-12 |