| NPI | 1245979657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 6001645-15) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN R822) |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2024-09-25 |