| NPI | 1497930804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 22048) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 22048) |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2011-12-13 |