| NPI | 1366968737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901601103) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: AZ D010371) |
| 122300000X Dentist (Licence: AZ D010371) | |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2022-05-18 |