| NPI | 1487787495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901010400) |
| Additional Taxonomies | 1223X0008X Dentist, Oral and Maxillofacial Radiology (Licence: MI 2901010400) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2007-07-09 |