| NPI | 1235807314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: FL DN28753) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901601015) |
| Enumeration Date | 2021-09-02 |
| Last Update Date | 2025-01-23 |