| NPI | 1033445838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN 13191) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NV 5833) |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2016-03-17 |