| NPI | 1174638613 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 9504) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MN 9504) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2016-12-09 |