| NPI | 1346762507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MD 17570) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1857682) |
| 1223G0001X Dentist, General Practice (Licence: MI 2901023206) | |
| 1223G0001X Dentist, General Practice (Licence: MA DN1857682) | |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2022-08-11 |