| NPI | 1821404641 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1857820) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NC 1007) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2022-01-18 |