| NPI | 1275974883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: MI 2901020971) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901020971) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2022-01-19 |