| NPI | 1144901745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 62263) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2023027070) |
| Enumeration Date | 2023-07-26 |
| Last Update Date | 2024-12-03 |