| NPI | 1003969023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 60601) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NH 3226) |
| Enumeration Date | 2007-01-21 |
| Last Update Date | 2020-01-27 |