| NPI | 1578139259 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901600911) |
| Additional Taxonomies | 122300000X Dentist (Licence: TX 41243) |
| 122300000X Dentist (Licence: MI 2901600911) | |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2025-03-11 |