| NPI | 1831432616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901021409) |
| Additional Taxonomies | 122300000X Dentist (Licence: ZZ A-14265) |
| 122300000X Dentist (Licence: WA DE60351086) | |
| Enumeration Date | 2013-03-31 |
| Last Update Date | 2015-10-16 |