| NPI | 1952830531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: NE 7415) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MN D13851) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2021-07-30 |