| NPI | 1285474288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D15057) |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2024-06-06 |