| NPI | 1144361106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D12637) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IA 08407) |
| Enumeration Date | 2007-02-10 |
| Last Update Date | 2014-03-05 |