| NPI | 1922447879 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1856435) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL11872) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2018-10-11 |