| NPI | 1457504151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901019968) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: SC 4539) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2009-06-08 |