NPI | 1689231078 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MN D14220) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D14220) |
Enumeration Date | 2019-05-22 |
Last Update Date | 2024-11-22 |