| NPI | 1912764457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MN D15026) |
| Additional Taxonomies | 122300000X Dentist (Licence: MN D15026) |
| 1223P0700X Dentist, Prosthodontics (Licence: MN D15026) | |
| Enumeration Date | 2024-03-01 |
| Last Update Date | 2024-10-21 |