| NPI | 1013201987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: DE G3-0000488) |
| Additional Taxonomies | 122300000X Dentist (Licence: DE G3-0000488) |
| 122300000X Dentist (Licence: VA 0401413118) | |
| 1223G0001X Dentist, General Practice (Licence: MD 14851) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2019-09-19 |