| NPI | 1275999104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DF100045) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901021760) |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2024-11-14 |