| NPI | 1407436017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901600873APP21) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901600873) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2022-11-21 |