| NPI | 1275653636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 15524) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901019913) |
| 1223G0001X Dentist, General Practice (Licence: PA DS036635) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2021-10-18 |