| NPI | 1356427942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901017597) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 5835) |
| 1223G0001X Dentist, General Practice (Licence: CA 55018) | |
| 1223G0001X Dentist, General Practice (Licence: NV 4949T) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2016-03-11 |