NPI | 1417006974 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D10273) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN 10273) |
Enumeration Date | 2007-01-10 |
Last Update Date | 2020-10-29 |