| NPI | 1881074540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NH 04226) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856893) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2021-01-12 |