| NPI | 1215487228 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D14814) |
| Additional Taxonomies | 122300000X Dentist (Licence: ND 2305) |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2024-07-16 |