| NPI | 1952785230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MI 2952000744) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL12642) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2021-09-13 |