| NPI | 1750519930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D12674) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D12674) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2015-02-17 |