| NPI | 1003530163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VA 0401418768) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901601551) |
| Enumeration Date | 2022-10-03 |
| Last Update Date | 2024-07-08 |