| NPI | 1073779633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2011001777) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 60589) |
| Enumeration Date | 2008-08-04 |
| Last Update Date | 2016-09-28 |