| NPI | 1043730237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN D14118) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: MA DN1857655) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2019-06-11 |