| NPI | 1023397080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NC 10808) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901020388) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2024-10-21 |