| NPI | 1134400781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 28870) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901020516) |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2024-04-29 |