| NPI | 1962959320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: RI DEN03358) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 11708) |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2017-10-12 |