| NPI | 1447669015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901023146) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: PA 390200000X) |
| Enumeration Date | 2014-08-08 |
| Last Update Date | 2022-11-08 |