| NPI | 1861640609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1855056) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 10008) |
| 122300000X Dentist (Licence: MA DN1855056) | |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2021-07-28 |