| NPI | 1114144581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 2901018881) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901018881) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-04-13 |