| NPI | 1770772808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: GA DNF000446) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2952000489) |
| 122300000X Dentist (Licence: GA DNF000446) | |
| 122300000X Dentist (Licence: MI 2901019069) | |
| 1223G0001X Dentist, General Practice (Licence: MI 2952000489) | |
| 1223G0001X Dentist, General Practice (Licence: MI 2901019069) | |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2023-04-13 |