| NPI | 1740317023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20084) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 20084) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-07-31 |