| NPI | 1043701899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 2901022572) |
| Additional Taxonomies | 122300000X Dentist (Licence: AZ D010139) |
| Enumeration Date | 2018-05-28 |
| Last Update Date | 2024-04-09 |