| NPI | 1598006363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN 14494) |
| Additional Taxonomies | 122300000X Dentist (Licence: MD 15312) |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2021-01-20 |