| NPI | 1619922507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: GA DNF000201) |
| Additional Taxonomies | 1223P0700X Dentist Prosthodontics (Licence: MI 2901013479) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2021-03-25 |