| NPI | 1497778492 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA DN19294) |
| Additional Taxonomies | 1223D0001X Dentist Dental Public Health (Licence: MA 19294) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2018-06-19 |