| NPI | 1346414885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI BP4553776) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 6493) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2010-08-25 |