| NPI | 1346770237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CA 102434) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MI 2901022330) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2020-12-18 |