| NPI | 1891854832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MN D11877) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: KY 7859) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2007-07-08 |