| NPI | 1992085724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: DC DEN1001320) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MI 2901029333) |
| 1223P0300X Dentist, Periodontics (Licence: MD 15543) | |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2020-10-20 |