| NPI | 1588284046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901600493) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901600493) |
| 122300000X Dentist (Licence: MI 2901600493APP20) | |
| 1223G0001X Dentist, General Practice (Licence: MI 2901600493APP20) | |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2021-11-30 |