| NPI | 1992364046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MN D14281) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MI 2951000657) |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2024-02-08 |