| NPI | 1194333138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MO 2020021817) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KS 61635) |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-12-16 |