| NPI | 1043413677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 11555) |
| Additional Taxonomies | 122300000X Dentist (Licence: MS 3736-14) |
| 1223G0001X Dentist, General Practice (Licence: MI 2901019604) | |
| Enumeration Date | 2007-06-10 |
| Last Update Date | 2020-06-10 |