| NPI | 1003039595 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D11150) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN 11150) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2024-02-23 |