| NPI | 1518228527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901020682) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 5315055325) |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2026-07-24 |