| NPI | 1386483063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MI 2901602290) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MI 2951000951) |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2024-07-29 |