| NPI | 1982080131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA DN122325) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901021295) |
| 1223P0700X Dentist, Prosthodontics (Licence: NY 059652) | |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2021-10-22 |