NPI | 1568741866 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI 2901020275) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901020275) |
Enumeration Date | 2011-08-04 |
Last Update Date | 2022-06-30 |