| NPI | 1427047638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MN D11831) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D11831) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2018-02-12 |