| NPI | 1558726042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901601223) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2952000485) |
| 1223G0001X Dentist, General Practice (Licence: OH 71-000246) | |
| Enumeration Date | 2015-12-28 |
| Last Update Date | 2023-03-29 |