NPI | 1124152632 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: MN D11958) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019-026815) |
Enumeration Date | 2007-03-15 |
Last Update Date | 2012-03-12 |