| NPI | 1245038777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS TBD) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO TBD) |
| 122300000X Dentist (Licence: MO TBD) | |
| 1223G0001X Dentist, General Practice (Licence: KS TBD) | |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-03-03 |