NPI | 1417943093 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MN D12092) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: TX 41346) |
Enumeration Date | 2005-09-20 |
Last Update Date | 2025-09-23 |