| NPI | 1972849032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223D0001X Dentist, Dental Public Health (Licence: MN S198) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DL11783) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2023-12-14 |