| NPI | 1952706582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901021430) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: PA DS039946) |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2021-02-17 |