| NPI | 1376293506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MN S246) |
| Additional Taxonomies | 122300000X Dentist (Licence: KY 10724) |
| Enumeration Date | 2022-03-29 |
| Last Update Date | 2025-08-25 |