| NPI | 1588033252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X2210X Dentist, Orofacial Pain (Licence: MN S201) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN R637) |
| 122300000X Dentist (Licence: MN S201) | |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2023-05-09 |