NPI | 1023134053 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 2901017277) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901017277) |
Enumeration Date | 2007-03-21 |
Last Update Date | 2025-08-13 |