| NPI | 1568500080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 9481) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21759MA) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-01-03 |