| NPI | 1558675348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1855526) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA dn155526) |
| Enumeration Date | 2010-08-04 |
| Last Update Date | 2019-02-21 |