| NPI | 1033727821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 61641) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2020022616) |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2021-10-11 |