| NPI | 1053048116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 62011) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2022019287) |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2022-12-01 |