| NPI | 1841480720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 9467) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901019559) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2013-08-01 |