| NPI | 1083497945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901602451) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: VA 0401418539) |
| Enumeration Date | 2023-08-15 |
| Last Update Date | 2025-06-09 |