| NPI | 1447263181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901014159) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302022074) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2016-07-23 |