| NPI | 1922237171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1856845) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: RI 3048) |
| Enumeration Date | 2009-07-09 |
| Last Update Date | 2015-05-15 |