| NPI | 1457774184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901601122) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401416320) |
| 1223G0001X Dentist, General Practice (Licence: CA 63326) | |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2021-11-09 |