| NPI | 1881144236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: TX 35880) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901021520) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2022-10-18 |