| NPI | 1992995443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MI 2901019368) |
| Additional Taxonomies | 122300000X Dentist (Licence: MI 2901019368) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MI 2901019368) | |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2018-04-30 |