| NPI | 1174982458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901602045) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN22776) |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2024-05-20 |