| NPI | 1013676733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NV 7554) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901601150) |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2022-12-09 |