| NPI | 1215074646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN S134) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN FF18) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2021-10-13 |