| NPI | 1750806394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: PA DS044945) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901022411) |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2025-05-22 |