| NPI | 1568503977 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: ME 3783) |
| Additional Taxonomies | 122300000X Dentist (Licence: ME 3783) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2014-01-21 |