| NPI | 1922159243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901016299) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 16299) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2020-07-20 |