| NPI | 1407344278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN FF70) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MN FF70) |
| 1223P0700X Dentist, Prosthodontics (Licence: MN FF70) | |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2018-04-27 |