| NPI | 1538482377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901017865) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: GA DN010855) |
| 1223G0001X Dentist, General Practice (Licence: SC 3001) | |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2010-03-08 |