| NPI | 1942400361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DL13561) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL12367) |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2018-10-04 |