| NPI | 1164975520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901600357) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN22188) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2024-09-05 |