| NPI | 1265844310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 290102230) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: ME 4388) |
| Enumeration Date | 2014-05-23 |
| Last Update Date | 2022-01-13 |