| NPI | 1669158143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901602366) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: FL DN28279) |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2025-08-15 |