| NPI | 1942458591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1855862) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 010102) |
| Enumeration Date | 2008-09-08 |
| Last Update Date | 2012-09-04 |