| NPI | 1134533466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 60995) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2014018209) |
| Enumeration Date | 2014-06-14 |
| Last Update Date | 2014-06-14 |