| NPI | 1174928857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: KS 61113) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 2014031462) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2019-10-11 |