| NPI | 1992778450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MN 10337) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MN 10337) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2007-07-08 |