| NPI | 1952389801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: KY 6538) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MI 2901017606) |
| Enumeration Date | 2006-01-01 |
| Last Update Date | 2007-07-08 |