| NPI | 1962633214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN014634) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2901020071) |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2023-07-05 |