| NPI | 1073052833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: MI 2901600891) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MI 2901600891) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2023-07-07 |