| NPI | 1689006173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1856783) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 62772) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2018-04-17 |