| NPI | 1336712207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D14844) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: TX 37572) |
| Enumeration Date | 2021-07-20 |
| Last Update Date | 2023-07-17 |