| NPI | 1447009444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2951000860) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MI 2951000860) |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2025-08-08 |