| NPI | 1871666024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 60101) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901019486) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2013-03-04 |