| NPI | 1972733038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901022300) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA DN1855094) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2021-11-19 |