| NPI | 1861935769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1859017) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 16070) |
| Enumeration Date | 2016-11-24 |
| Last Update Date | 2021-07-12 |