| NPI | 1245433044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: NV 5794) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901019321) |
| 1223G0001X Dentist, General Practice (Licence: MI 2901019321) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2016-09-28 |