| NPI | 1508358664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AZ D011244) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901022592) |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2026-02-11 |