| NPI | 1871842229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NH 03931) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856977) |
| 1223G0001X Dentist, General Practice (Licence: CA 61851) | |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2020-10-07 |