| NPI | 1598898744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MI 2901016012) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901016012) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2008-06-17 |