| NPI | 1093036097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2010028679) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 60687) |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2016-10-12 |