| NPI | 1003229733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401417708) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901022515) |
| 1223G0001X Dentist, General Practice (Licence: NC 9775) | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2021-12-15 |