| NPI | 1649602400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901021028) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901021028) |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2023-05-22 |