| NPI | 1508231143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1857142) |
| Additional Taxonomies | 122300000X Dentist (Licence: RI DEN03292) |
| Enumeration Date | 2015-12-08 |
| Last Update Date | 2016-04-28 |