| NPI | 1235690405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: MI 2901601865) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901601865) |
| 122300000X Dentist (Licence: NY 062717) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2023-11-30 |