| NPI | 1851650907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 1856243) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: MA DL 11543) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2017-12-01 |