| NPI | 1477694115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901017640) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 17640) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2021-09-30 |