| NPI | 1821435397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901022540) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CA 48271) |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2021-11-04 |