| NPI | 1669952651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA dn1858201) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1858108) |
| Enumeration Date | 2018-08-18 |
| Last Update Date | 2024-09-11 |