| NPI | 1881814275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MI 2901019178) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 19178) |
| 1223G0001X Dentist General Practice (Licence: MI 19178) | |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-10-07 |