NPI | 1518080308 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: FL 17472) |
Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MI 2901017394) |
Enumeration Date | 2007-04-09 |
Last Update Date | 2025-05-05 |