| NPI | 1225152069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 2901019265) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901019265) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2008-06-17 |