| NPI | 1013355825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2013018444) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 60984) |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2015-08-19 |