| NPI | 1508052374 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: MI 2901018293) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901018293) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2007-09-20 |