| NPI | 1134942709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI 5315251627) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 5315251627) |
| 1223G0001X Dentist, General Practice (Licence: MI 5315251627) | |
| Enumeration Date | 2024-11-04 |
| Last Update Date | 2024-11-04 |