| NPI | 1235887308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: KY 10785) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: KY 10785) |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2024-06-25 |