| NPI | 1154056554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 14986) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 063576) |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2024-10-28 |