| NPI | 1700910007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20485) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NH 03723) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2009-07-14 |