| NPI | 1962025791 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 5315216947) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901600465) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2024-02-13 |