| NPI | 1740386853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ND 1965) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D12112) |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2021-01-27 |