| NPI | 1255725115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901022840) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 105884) |
| 122300000X Dentist (Licence: ND 2295) | |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2024-11-07 |