| NPI | 1770955114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901021756) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IN 12012398A) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2015-10-26 |