| NPI | 1700223237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1856472) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 10971) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2018-05-02 |