| NPI | 1487043618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MI 2901600775) |
| Additional Taxonomies | 1223P0221X Dentist Pediatric Dentistry (Licence: MA DL13738) |
| 1223P0221X Dentist Pediatric Dentistry (Licence: MA DL13958) | |
| Enumeration Date | 2015-01-12 |
| Last Update Date | 2021-09-17 |