| NPI | 1720784630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901602064) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA DDS108452) |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2024-06-11 |