| NPI | 1881394591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901602446) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1859977) |
| Enumeration Date | 2023-03-09 |
| Last Update Date | 2024-12-30 |