| NPI | 1811480155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ND 2353) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901022691) |
| 1223G0001X Dentist, General Practice (Licence: MI 2901022691) | |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2019-07-02 |