| NPI | 1134500986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 61196) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2015018297) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-06-17 |