| NPI | 1194178806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901602689) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OR D10651) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2026-03-17 |