| NPI | 1215374335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: SD D1361) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901020964) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2022-09-21 |