| NPI | 1619961760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME DEN4552) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 08279) |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2022-07-21 |