| NPI | 1821426701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1856431) |
| Additional Taxonomies | 122300000X Dentist (Licence: ME 4272) |
| 1223G0001X Dentist, General Practice (Licence: ME 4272) | |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2024-04-03 |