| NPI | 1841587664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DL11146) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401413964) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2014-05-05 |