| NPI | 1558775809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NH 04053) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1856514) |
| Enumeration Date | 2014-06-15 |
| Last Update Date | 2016-06-30 |