| NPI | 1356503429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MI 2901019882) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2901019882) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30.024965) | |
| 122300000X Dentist (Licence: OH 30.024965) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2022-05-11 |