| NPI | 1093191223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 61216) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2018004823) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2023-11-02 |