| NPI | 1134611411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 61514) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2018017817) |
| Enumeration Date | 2018-06-03 |
| Last Update Date | 2020-10-15 |