| NPI | 1992767545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MI 2901602475) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 9245) |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2025-07-09 |