| NPI | 1497130926 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AK 166942) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901021660) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2021-01-25 |