| NPI | 1467941211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D14481) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 1001932-15) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2021-11-29 |