| NPI | 1306405212 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D14513) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CO DEN.00204004) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2021-03-24 |