| NPI | 1033558382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: FL DN 21418) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901020958) |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2023-05-29 |