| NPI | 1215083613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901018443) |
| Additional Taxonomies | 122300000X Dentist (Licence: FL DN16977) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2019-12-16 |