| NPI | 1760817159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ME DEN4418) |
| Additional Taxonomies | 122300000X Dentist (Licence: SC DGD.8275 GD) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2021-09-01 |