| NPI | 1558471367 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 16434) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NH 2031) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2016-02-22 |