| NPI | 1841493038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IA 08770) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901019312) |
| 1223G0001X Dentist, General Practice (Licence: MI 2901019312) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-01-10 |