| NPI | 1487030300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901022150) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: SC 10120) |
| 1223G0001X Dentist, General Practice (Licence: TX 31213) | |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2024-05-01 |