| NPI | 1245915438 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: KS 62116) |
| Additional Taxonomies | 122300000X Dentist (Licence: MO 2023023255) |
| Enumeration Date | 2023-06-16 |
| Last Update Date | 2023-06-16 |