| NPI | 1902828171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: FL DTP397) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 291015607) |
| 1223G0001X Dentist, General Practice (Licence: NC 0096) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2010-11-19 |