| NPI | 1518003292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 2901600788) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: NY 050909-1) |
| 1223G0001X Dentist General Practice (Licence: TX 29548) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2025-03-15 |