| NPI | 1699220285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: FL DN26644) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901021907) |
| 1223G0001X Dentist General Practice (Licence: MI 2901021907) | |
| 1223G0001X Dentist General Practice (Licence: CO 00203903) | |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2022-05-03 |