| NPI | 1972984359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D13727) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MT DEN-DEN-LIC-9606) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2016-06-27 |