| NPI | 1790953487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NH 03705) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 21361) |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2009-04-21 |